Cost-Effectiveness of the Adjuvant Recombinant Zoster Vaccine in Japanese Adults Aged 65 Years and Older.

Introduction: The incidence of herpes zoster (HZ) rises steeply after the age of 50 years and the number of HZ cases and complications such as postherpetic neuralgia (PHN) is predicted to increase because of the ageing population. The objective of this study was to estimate the cost-effectiveness of recombinant zoster vaccine (RZV) compared with no vaccine for the Japanese population aged ≥ 65 years.

Methods: A multi-cohort static Markov model with a cycle length of 1 year was used to follow a hypothetical cohort of 1 million people aged ≥ 65 years over their remaining lifetime.

[Problems with Advertisements for Health Foods].

We have been studying the way advertisements for medicines have been monitored by the Health, Labour and Welfare Sciences Research Grants. In the last fiscal year, we identified products that were being advertised to general consumers, such as OTC drugs and designated quasi-drugs, and made recommendations to the Ministry of Health, Labour and Welfare on the methods of advertisement. Members of our research group, including physicians, pharmacists, and consumers, pointed out that advertisements for so-called health foods and foods with functional claims were much more unregulated than those for drugs, including OTC drugs.

The Potential Public Health Impact of Herpes Zoster Vaccination of People Aged ≥ 50 Years in Japan: Results of a Markov Model Analysis.

Introduction: The aim of this study was to compare the public health impact of introducing two herpes zoster (HZ) vaccines into the vaccination programs for the Japanese population aged ≥ 50 years: a single-dose Varicella Vaccine Live (VVL) or a two-dose adjuvanted Recombinant Zoster Vaccine (RZV).

Methods: A multi-cohort static Markov model was developed to follow age cohorts (50-59, 60-69, 70-79 and ≥ 80 years) over their remaining lifetime. Japan-specific data inputs for the model were obtained from Japanese data sources.

[Greeting and General Statement by the Organizer].

Regulatory science is growing increasingly important, and the Health and Medical Strategy of the Japanese government reflects this. How regulatory science is covered in pharmaceutical education is an urgent issue. Education on regulatory science is also part of the modified version of the model core curriculum in the six-year pharmaceutical course that was introduced from 2015.

Cost-Effectiveness Evaluation of the 10-Valent Pneumococcal Non-typeable Haemophilus influenzae Protein D Conjugate Vaccine and 13-Valent Pneumococcal Vaccine in Japanese Children.

Introduction: Diseases caused by Streptococcus pneumoniae represent a major public health problem. The purpose of this study was to compare, in the Japanese context, the projected health benefits, costs and cost-effectiveness of the latest generation of pneumococcal conjugate vaccines which may provide important insight into the potential public health impact of interventions in the context of local disease-specific epidemiology.

Methods: A Markov model was used to compare two vaccination strategies which involve routine infant immunization with either the 13-valent pneumococcal conjugate vaccine (PCV-13; Prevenar 13™, Pfizer, Pearl River, NY, USA) or the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix™, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) over a time horizon of 5 years from the healthcare provider and societal perspectives.

Contribution of antimicrobial stewardship programs to reduction of antimicrobial therapy costs in community hospital with 429 Beds --before-after comparative two-year trial in Japan.

Objectives: Do antimicrobial stewardship programs (ASPs) contribute to reduction of antimicrobial therapy costs in Japanese community hospitals? To answer this health economic question, a before-after comparative two-year trial in a community hospital in the country was designed.

Methods: The study was conducted at National Hospital Organization Tochigi Medical Center, a community hospital with 429 beds. We compared six-month period before-ASP (January 2010 to June 2010) and 24-month period after ASP (July 2010 to June 2012) in primary and secondary outcome measures.

Acceptable incremental cost effectiveness ratio for use of new drugs, cases in statin therapies.

As it is an urgent issue to contain increasing healthcare expenditures, unlimited reimbursement of pharmaceuticals continues to be controversial. The objective of this study is to identify acceptable incremental cost effectiveness ratios between new and conventional therapies. Clinical study data for five statin therapies were used to indicate treatment effectiveness and incremental costs were indicated by price premiums at price listing.

[Detection of adverse drug reactions with the use of a simple questionnaire].

In order to detect adverse events in patients at pharmacies, a questionnaire was developed to evaluate adverse drug reactions that may come from the use of pharmaceuticals. The questionnaire enabled pharmacists to assume possible adverse drug reactions while they dispense a prescription but was designed not to make patients sensitive. An investigation method was developed to detect adverse drug reactions that may be attributable to drug treatment by leading patient natural complaints while pharmacists provide drug treatment guidance to patients.

[Cost-effectiveness of salmeterol/fluticasone combination therapy vs. fluticasone propionate in Japanese asthmatic patients].

We commenced to estimate the economic impact of salmeterol/fluticasone combination (SFC) therapy compared to fluticasone propionate (FP) therapy for asthma control in Japanese patients. A Markov model with five health states, developed by Price in 2002, was used. 1-week transition probabilities among status of asthma management were obtained from literature and epidemiological data from public data base.

[Patient needs for consultation with pharmacists].

More prescription drugs are dispensed by pharmacists rather than doctors in response to government healthcare reform. However, the results of our preliminary survey suggested a hypothesis that patients were not always satisfied with explanations provided by pharmacists upon dispensing, and therefore patient satisfaction might be enhanced if pharmacists spent more time on consultation services. The survey was conducted in 1,800 people.

[Reasonable dispensing fee for patients].

The actual pharmacist workload is not always reflected in dispensing fees, while patients do not always understand the system of dispensing fees. In this study, the relation between the time required for dispensing and prescription details and that between the time required for instruction on drug administration and instruction details in nine pharmacies in Chiba prefecture were investigated. As a result of linear regression analysis, it was suggested that, compared with doses, the number of drug items more greatly affected the time required for dispensing.

Pharmacoeconomic analysis of hypertriglyceridemia treatment at medical institutions.

It has been demonstrated that HMG-CoA reductase inhibitors effectively decrease low density lipoprotein and total cholesterol levels, and presently, HMG-CoA reductase inhibitors are most widely used in hyperlipidemia treatment. On the other hand, it has been demonstrated that fibrate agents decrease triglyceride levels more effectively compared to HMG-CoA reductase inhibitors. A cost-effectiveness study comparing fenofibrate, a fibrate agent, and atorvastatin was therefore conducted in hypertriglyceridemia patients.

Contributions of pharmacists through the promotion of proper drug use.

The contents of pharmacist interventions, which were carried out by the ward pharmacists in their routine pharmacy service activities, were sorted and analyzed to evaluate the contributions of pharmacists. In the ward where pharmacists were stationed, there were a total of 196 cases of pharmacist intervention. The prescription was changed in 170 cases, giving a rate of prescription change of 86.

[Objective evaluation of generic-specific drug information].

Growth in the use of generic drugs remains flat in Japan, and one of the reasons cited is information availability. We previously showed that the amount of information available on generic drugs differs greatly from one pharmaceutical industry to another, though, on average, it is inferior to that for original, brand name drugs. This report looks at information on individual generic drug products, rather than the active ingredients contained therein.

[Cost-effectiveness of fluticasone propionate for asthma episodes in Japanese patients with asthma--Fluticasone Investigation of Asthma Episode (FINE) study].

Background: To discuss and estimate the economic benefits gained by fluticasone propionate (FP) for patients with asthma over hospitalization, emergency room visit, unscheduled visit, and absence (representative by asthma-related episode).

Method: Asthma-related episodes in pre and post 6 months of FP use were derived from a survey of FP on asthma-related episodes (FINE study). Medical cost was evaluated by macro-cost estimate and productivity loss by human capital approach.

The realities and medical expense of hospitalization that originates in outpatient medicine treatment.

Problems associated with outpatient pharmacotherapy may require hospitalization. However, such hospitalization may be prevented if pharmacist's pharmaceutical care (PC) is given. We investigated the reasons for hospitalization in medical institutions and medical expenses were calculated.

Cost-effectiveness of including salmeterol in asthma therapy in a primary care setting in Japan.

To discuss and estimate the clinical and economic benefits obtained during combination therapy with inhaled corticosteroids (ICS) plus salmeterol (SLM) for Japanese patients with asthma on the basis of the Global Initiative for Asthma (GINA) Guidelines. Fifty-four cases aged>16 years with either moderate persistent asthma (step 3) or severe persistent asthma (step 4) were assessed in a retrospective survey. Participants must have been a patient at the author's clinic continuously from June 2001 and been users of SLM for more than one year.

[Evaluation of information for generic drugs based on importance and necessity].

Limited use of generics in Japan has been justified on the basis of problematic quality, distribution and information. Of these three problem areas, the state of provision of information in particular has never been objectively evaluated. We therefore sought to evaluate information according to its necessity and importance to medical practice.

[Comparison of the effects of prophylactic antibiotic therapy and cost-effectiveness between cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway].

The present study was designed to investigate the effects of prophylactic antibiotic therapy and the cost-effectiveness of Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway. 157 patients (62 in the CEZ group and 95 in the SBT/ABPC group), who underwent surgery for gastric cancer at the First Department of Surgery of our hospital, were investigated. There was no significant difference between the groups with regard to sex, age, incidence of complication, stage of cancer, surgical method, operative time and blood loss, length of hospitalization, the appearance of systemic inflammatory response syndrome (SIRS), changes body temperature, white blood cell count (WBC), C-reactive protein (CRP), or clinical outcome of postoperative care by a nurse during post-operation for 7 days.

Objective evaluation of generic drug information.

Pharmacists active in health care venues need to be able to evaluate generic drugs in terms of effectiveness, safety, and economy to ensure that they are used appropriately. As part of the ongoing study of these factors, we carried out an objective evaluation of information provided for generics. A minimum of 20 commercially available products was considered for each pharmaceutical ingredient.

[Calculation of drug information necessity factor of generic drugs].

The utilization of generic drugs has been promoted, but there is concern about the insufficiency of the information provided on generic drugs. To make an objective evaluation of the amount of information supplied by generic drug manufactures, we tried to quantify the information supply. The information described in the package insert and the interview form were used in the evaluation.

[Pharmacoeconomics].

The pharmacoeconomics is relatively new field in pharmaceutical science. In August, Pharmaceutical Society of Japan published "model core curriculums for pharmacy education" and pharmacoeconomics is included in it. As the Japanese health insurance system is composed of fee for service system and small patients' co-payment, physicians as well as patients have not needed pharmacoeconomic analysis.